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Blood Bank labsite
Transport of Blood Components Blood may be obtained by one of the following methods: * pneumatic tube * unit personnel picking up at the Blood Bank window Room 2F225 University Hospital * transport of blood components using phlebotomy service when the blood order is large or the pneumatic tube system cannot be used. When calling the Blood Bank for pneumatic tube delivery of a unit of blood provide the following: * Transport personnel must present to Blood Bank personnel written notification indicating following: ** Blood components will be released to physicians and registered nurses on the basis of an oral request stating this information. ** Patient care units Without a Blood Refrigerator: Only one unit of blood will be released at a time for a patient unless the patient has two intravenous lines in place that allow for the simultaneous administration of two components. ** Patient Care Units With a Blood Refrigerator: Multiple blood units will be released only to patient care units with monitored blood refrigerators. Receipt of Blood Components The person receiving the blood being transported or opening the tube at the receiving location must immediately upon receipt ** Red Blood Cell and plasma components must be stored between 1 and 6 C and the temperature during transport cannot exceed 10 C. Refrigerated blood components will warm to above 10 C in approximately 30 minutes after removal from refrigeration. ** Platelets and Cryoprecipitate are stored at room temperature. These components may be used until the outdate time on the label. ** Consult with the Blood Bank if there is any question about the suitability or identification of a blood component. Special Labels *** When blood is released for transfusion under unusual circumstances a special notation will be indicated on the Transfusion Record Form. *** This information will often suggest to physicians and nurses that particular caution must be exercised during transfusion, and that the blood transfusion should be terminated at the first sign of an untoward reaction. *** Personnel initiating the transfusion who have questions concerning the significance of this information should contact the Blood Bank. IMMEDIATELY PRIOR TO BLOOD TRANSFUSION Pretransfusion Vital Sign Documentation *** To provide a baseline, record the patient's blood pressure, pulse, respirations and temperature in the chart or on the transfusion record form If a patient is febrile, consideration should be given to postponement of blood transfusion, since the fever may mask the development of a febrile reaction to the blood component itself. ** Verify physician's orders for transfusion and any that any pretransfusion medications have been administered ** Perform bedside verification of patient and component Using the ** labels on the bag, ** the Transfusion Record Form and ** the patients attached positive patient identifier. Two qualified individuals must These steps must never be bypassed. DO NOT START the transfusion if there is any discrepancy. Contact the Blood Bank. Initiating the Transfusion *** Immediately before transfusion, mix the unit of blood thoroughly by gentle inversion. *** Follow the manufacturer's instruction for the use of special filters and ancillary devices. Additional administration instructions for selected components are printed at the end of this chapter and are available upon request from the Blood Bank. *** If any part of the unit is transfused, the unit is considered transfused. Flow Rates During the Transfusion Document See Chapter 7 for details concerning the signs and symptoms of a transfusion reaction. If the patient has a preexisting fever The need for transfusion must be balanced with the risk of transfusion. Contact the patient’s physician to determine if pretransfusion medications should be administered. If a patient is being transported with blood hanging Patients should not be transported with blood components infusing unless accompanied by a clinician who can monitor and respond to a potential reaction. Additionally, the receiving clinic/area must have a clinician who can manage a patient while they are receiving blood components. Medications ** Do not add medications directly to a unit of blood during transfusion. ** Medications that can be administered "IV Push" may be administered by stopping the transfusion, clearing the line at the medication injection site with 5-10 mL of normal saline, administering the medication, reflushing the line with saline and restarting the transfusion. Units entered and not transfused If a unit of blood or a blood component has been entered for any reason by personnel not working in the Blood Bank, and the unit has not been transfused * Record on the transfusion Record Form the volume transfused as "NONE" * Indicate the disposition of the unit "Discarded on patient unit" and sign and date the notation. * Return the Transfusion Record Form to the Blood Bank If Components Are No Longer Needed To avoid unnecessary waste of blood resources, notify the Blood Bank staff immediately if components are no longer needed for a patient, as the component may be suitable for transfusion to another patient. Return any unneeded units to the blood bank. At the Termination of an Uncomplicated Transfusion After the completion of each uncomplicated transfusion, the responsible physician or nurse should verify that the "Transfusers Must Complete" section of the Transfusion Record Form is complete, including *** date and time transfusion was stopped *** volume of blood infused *** Check the box documenting the presence/absence of a transfusion reaction. Discontinue the isotonic saline solution used to initiate the transfusion after the completion of the transfusion unless specifically ordered. Document the patient's response to the transfusion in the patient's medical record. If a Transfusion Reaction is Suspected ** Stop the transfusion ** Maintain the IV. ** Save the bag and attached tubing and refer to Chapter 7 for additional instructions. Disposal of Blood Bags If No Reaction is Suspected Discard empty blood bags with attached blood infusion sets on the patient unit in a biohazard waste container such as a red bag. Transfusion Record Form Distribution Following completion of the form, the white copy of this form should be retained in the patient unit for attachment to the patient's chart; the pink copy of the form must be returned to the Blood Bank in hospital mail. SPECIAL INSTRUCTIONS FOR HEMATOPOIETIC PROGENITOR CELL (HPC) INFUSION Autologous stem cells are the patient's own stem cells that are harvested from the marrow or peripheral blood and then cryopreserved. Allogeneic Bone Marrow is fresh stem cells taken from a donor's bone marrow. Allogeneic stem cells are taken from the peripheral blood by apheresis. After collection these cells may be cryopreserved. |- style="height:0px" | style="border:0pxsolid#000000;vertical-align:top;padding:0px0px0px0px"| | style="border:0pxsolid#000000;vertical-align:top;padding:0px0px0px0px"| | style="border:0pxsolid#000000;vertical-align:top;padding:0px0px0px0px"| |}